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Serving Brier, Edmonas, unu 12425 Meridian Ave S INSPECTION REPORT
SI�lyUligri:IS�T CO. ��� t, <. � ❑ EDMONDS
FIRE`� Mountlake Terrace Everett, WA 98208 ❑ BRIER
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�`�Phone (425) 551-1200 ❑ MOUNTLAKE TERRACE
www.FireDistrict].org Fax (425) 551-1272 ❑ UNINCORPORATED
LOCATION: 109 Main Street Suite 2 98020
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BUSINESS NAME: PHONE:
MAILING 109 Main Street, Suite 2, Edmonds, WA 98020
ADDRESS:
BUSINESS OWNER: HOME PHONE:
Chrstel, Teena 11 M SOL rce co+�Ju• +i nc� ���
EMERGEN -1: / � ME 40 E: 2064844107
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EMAIL: II/J
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NAME OF INSPECTOR:
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CURRENT CITY YES No
BUSINESS F LICENSE
INITIAL INSPECTION D
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
tst RE -INSPECTION 2nd RE -INSPECTION EXTENSION FINAL RE -INSPECTION € VIOLATIONS
DATE DUE: DATE DUE: GRANTEDTOI ;DATE DUE' , CITED:
PERSON PERSON _ i PERSON
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DATE. DATE. DATE; 3
VIOLATIONS VIOLATIONS PRE -CITATION CITATION ISSUED j
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2 6 2 6 DATE. SECTION.
RETURN RECEIPT
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DISPOSITION.
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LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO
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